Provider Demographics
NPI:1356333108
Name:HINTON, STEPHEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:HINTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1700 OLD LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-9615
Mailing Address - Country:US
Mailing Address - Phone:270-789-6082
Mailing Address - Fax:270-789-6080
Practice Address - Street 1:95 KINGSWOOD DR
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9604
Practice Address - Country:US
Practice Address - Phone:270-465-3812
Practice Address - Fax:270-465-8352
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0989810OtherMEDICARE HOSPITAL
KY64233935Medicaid
KY64233935Medicaid
KY1383802Medicare PIN
KY0989810OtherMEDICARE HOSPITAL